静脉注射氨基酸对功能的保护作用:随机对照试验的系统审查和元分析
Wei Jiang1, Keran Shi1, Jun Shao1
1Department of Critical Care Medicine, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou 225001, China; Department of Critical Care Medicine, Northern Jiangsu People's Hospital, Yangzhou 225001, China.
Journal of critical care
|October 24, 2024
概括
静脉注射的氨基酸可以降低急性损伤 (AKI) 的发生率,并增加高风险患者的尿量. 然而,它们不会显著影响死亡率或需要替代疗法的需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 关键护理医学 关键护理医学
- 外科手术患者管理
背景情况:
- 急性损伤 (AKI) 是重症患者和接受心脏手术的患者经常出现的并发症.
- 静脉注射的氨基酸可以增强透和功能储备,但它们在预防AKI方面的有效性尚未得到充分证实.
研究的目的:
- 对随机对照试验 (RCT) 进行全面审查,评估静脉注射氨基酸的保护潜力.
- 评估静脉注射氨基酸补充对AKI和相关结果发生率的影响.
主要方法:
- 在EMBASE,PubMed,MEDLINE和Cochrane图书馆搜索到RCT的时间为2024年7月2日.
- 从包含的RCT中提取了患者特征和功能结果的数据.
- 使用偏差风险2 (RoB2) 工具评估研究质量,并使用随机效应模型合成数据.
主要成果:
- 包括7项与505名患者进行的RCT;静脉注射氨基酸显著降低了AKI发病率 (RR:0.81) 和增加尿量 (MD:308.87).
- 没有观察到30天或90天死亡率的显著降低或需要脏替代疗法.
- 亚组分析表明,静脉注射氨基酸,特别是心脏和主要血管外科手术患者,以及手术内给予的AKI发病率降低.
结论:
- 静脉注射的氨基酸在高风险的AKI患者中对功能产生保护作用,特别是心脏手术后.
- 该疗法有效降低了AKI的发生率,并改善了尿液输出.
- 在置换疗法 (KRT) 或整体死亡率方面没有发现显著的益处.
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